Hi,
Does anyone know what statistical methods would be appropriate for examining the effects of structural determinants, through a mediator, on health outcomes? All of these would be different units of analysis. For example, a political/structural variable at the state level --> state budget --> health outcomes in actual people in that state. And how do researchers deal with the time lag issue, that is, how to decide when to measure health outcomes in relation to the upstream structural variables, and the issue of people moving in and out of states or other geographical units?
We just finished a study using state-and year fixed-effects models, and I want to follow it up with a mediational model.
I feel like this is a crucial question for examining social/political determinants of health & health inequities, but I have no idea what kind of analysis would be appropriate. A lot of the studies I have looked at so far are more in the form of predictor --> outcome & not in the form of predictor --> mediator --> outcome. Or they follow individual people in longitudinal studies, but then the focus is on the people as they move through time and space, not as much on the political/structural determinants in a specific jurisdiction.
I'm wading into areas that are far, far away from what I was trained in decades ago, so I'd appreciate any help or any examples of studies that have tried to tackle this question.
Thanks,
Canan
--
Canan Karatekin, Ph.D.
Associate Professor | Institute of Child Development, 206C
| icd.umn.edu